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MR. WILLIAM WISE

Optician >> Technician/Technologist >> Eye and Vision Services Providers

Registrant NPI Number: 1588201420

Individual Registrant:
MR. WILLIAM  WISE 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
410 NORTH ST  OTISVILLE, MI 48463-9705 US
Tel: 810-374-6410  Fax: --

Contact information for business:
410 NORTH ST  OTISVILLE, MI 48463-9705 US
Tel: 810-374-6410  Fax: --

Registration Information:
NPI: 1588201420
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y156FX1800XEye and Vision Services Providers
Technician/Technologist
Optician

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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